1996 Volume 10 Issue 4 Pages 510-514
A 75-year-old man presented with pulmonary infiltrates in the right upper lobe. Computed tomography of the chest confirmed these infiltrates ; no lymphnode metastasis was detected. Bronchoscopy revealed a polypoid tumor obstructing the distal right B2b bronchus. Transbronchial tumor biopsy via fiberoptic bronchoscopy revealed squamous cell carcinoma.
Right upper lobectomy was performed, with removal of mediastinal lymphnodes seen intraoperatively. A polypoid tumor was present near the entrance of right B2b. The central part of the tumor had infiltrated the inner aspect of the bronchial cartilages but remained within the bronchial wall. Unexpectedly, pretracheal lymphnode metastasis was noted, so the pathological staging was T1N2M0 stage IIIA. Postoperatively, he received chemotherapy. Seventeen months later, the patient is well with no evidence of recurrence.
We believe that mediastinal lymphnode dissection should be done even in cases of early stage hilar type lung cancer except for carcinoma in situ.